Picsara HCA Training2015-11-23

Some background

• Name is fictional

• Derived from a Telemedicine system Called Migra

• Started with 7.5 in 2003

• General Image/Media management system for the healthcare.

• Complement to EPR, LIS & other ”IS”, not a replacement.

• Complement to PACS, not a replacement. (outside radiology)

• DICOM/NON DICOM Hybrid

Migra

What is Picsara?

Without

•Images scattered over the hospital, no backup.

•Images for one patient stored locally in several devices = running and guessing.

•Problems connecting HW to suitable SW

•Paper copies in physical folders.

•Images in folders or even private devices.

•No Security or logging

•No EPR or other integration or PatientID validation

•Lack of workflow

•Lots of time spent searching, grouping, comparing, if at all.

Why Picsara?

With

•Centrally stored with back up.

•Access from anywhere via the EPR, single click

•Complete overview, search, combine, compare

•Picsara connects to many sources, (client or server)

•Images immediately available from anywhere.

•Uniform way of working, simplified workflow.

•Built in security and logging w. Audit trail

•Integration with EPR or other ”IS”, SSO and patient validation.

•Saves time, ROI, helps fulfill legal aspects.

Why Picsara?

Dermatology

Opthalmology

Endoscopy Ultrasound

SurgeryMicroscopy

Where?

Etc….

Hardware agnostic/neutral?

Workflows

(Picsara can be started from the start menu, or if you have a short cut on your desktop)

1.Log in

2.Select “New Case” in Picsara.

3.Select the “Inpatient case form” in Picsara.

4.Picsara presents a case form without any prepopulated information.

5.Enter the applicable patient demographics and information.

6.Add clinical information into the case form.

New Case, Inpatient

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• The WL is filtered on department when displayed to reduce the number of hits.

• Sorting, Default on surname (alphabetic order).

• Select an order by double clicking or mark + “select”

• The user shall be able to refresh the worklist in the following ways; by initiating a new case, by selecting the refresh button in the case form and by refreshing from the worklist.

Use case steps

1. Register an OE message in Meditech.

2. Enter the procedure for the video footage/still images, to trigger the order from Meditech to the worklist service.

3. The order is filed.

4. After a four minute delay, the order will appear in the worklist.

WorklistClick to sort the column

Select

Filter the list with search fields

(Picsara can be started from the start menu, or if you have a short cut on your desktop)

1.Log in

2.Select “New Case” in Picsara or F7

3.Select any of the Outpatient case forms in Picsara Neurorehab Therapy Portland or Physiotherapy Portland

4.The worklist is displayed

5.Select order Picsara creates a new case by automatically populating the case form with the information in the order selected from the worklist

6.Validate the patient demographics

7.If the order retrieved is correct, the Therapist starts to add clinical information into the case form Alternative steps

4a) Utilize the “Search filter” to find the correct patient/order.

7a) Select a new order by clicking the “refresh” button. The worklist is presented again and the user can select a different order.

New Case, Outpatient

Select form

WL shows

A Case is created

Workflow for capturing videos/images

Procedure 1 capture patients one at a time1.The Therapist starts a new case in Picsara 2.The Therapist goes away to the appropriate location and uses the video camera to capture the videos/images. 3.The Therapist comes back to the computer and uploads the video/image from the camera to the initiated case in Picsara.

Procedure 2, capture multiple patients on the same card1.The therapist captures videos/images of one or several patients using the video camera.2.Suggestion: write the X-number and a running number (order of today’s patients e.g. Patient 1, patient 2) on a piece of paper and record this in the beginning of each clip, to tie the clip to the patient.3.The therapist initiates the cases as he/she is uploading the different videos/images.

NOTE: Sound requires speakers or headphones and a PC sound card to be heard. Sound is recorded if the device used has a microphone built in and this is interleaved with the video by the device.

Long video clips(To be evaluated by the users)

Videos directly from the camera may become too large after 8-10 min. To handle this, either use trimming and joining to heavily reduce the length and size, or record the clip over again using the Enciris capture card, which is set to change the compression and format in real time, while recording.

- The procedure field allows for free text to be entered. - It’s possible to enter a maximum of 50 characters in the free text field.- It’s possible to enter comments related to the captured media.

Adding media to the case

Procedures included in the list:ADL/FunctionBehavioural observationCognitive assessmentCommunicationFeeding/SwallowingHome programmeMobility/Gait analysisObservation Outcome MeasurePositioningROMSkin/Pressure areas Swelling

1. Select the images for the report by ctrl-clicking the Word icon in the case form.

2. Select the Therapy report template.

3. Make the appropriate choices (exporting selected images, exporting all images, including measurements etc.).

4. Picsara exports the case information to the predefined Word template.

5. Word is opened and the Therapy assessment report is presented.

6. Add contact information to the Therapist who created the case and possibly also email-addresses to clinicians to be CC:d.

7. The Therapist saves the Word report to the case by choosing “Save As” and selecting PDF, which is then dragged and dropped into the case (or choose “add file” from the case menu and browse for the PDF).

8. Lock the case.

Reporting

Locking and updating a case

When you are done working with a case, it can be locked, to secure that the information can’t be changed by mistake.

1.Click on the yellow lock in the case

2.Enter your password and OK

3.The lock turns red.

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Locking and updating a case

If there is a need to update a locked case, a copy can be created.

1.Click on the red lock

2.Click OK in the dialog saying a copy will be made

3.Now an unlocked copy is shown on top of the old version.

4.Make your changes and lock the copy again.

This procedure can be repeated and no media is duplicated on the server.

From the system information tag, you can open previous versions side by side to view the differences.

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Search filter

Search filter

Drag and drop or double click to open the file.

Press “Search” or F8 to activate the search filter, if not visible

Combine fields to narrow the search

Found set

Working with Picsara

User interface

Video capture

Compare/measure videos & stills, side by side

Choose your own buttons/tools

User interface

• Full screen

• Hanging/Views

• Group

• Zooming/panning

• Sync (Advanced)

• Annotate

• Measure

• Choose buttons/docking

• Open

• Compare, side by side

• Measure

• Annotate

• Adjusting; Sharpen, white balance, cropping

Work with images

• Viewing

• Change speed

• Trimming

• Joining

• Capture frame/stills

• Side by side

 

Play and cut video (See Quick guide): • 1. Current position/time HH:MM:SS:FF, where FF indicates frame

• 2. Go to start of clip

• 3. Play, plays from your current position and changes to a pause symbol while playing

• 4. Stop and go to start of clip

• 5. Loop, plays the clip in a continuous loop

• 6. Set bookmark

• 7. Set cue point start

• 8. Set cue point end

• 9. Cut video between cue points

• 10. Total length of clip

Work with video

(New: Playback Speed)

USB:

1.Plug in the USB stick

2.Right click on the file to export, in the case (Video or still) and choose “Save as”

3.Browse the USB stick and save.

4.Preferably do a “Safe Eject” by right clicking on the USB icon on the desktop and selecting “Eject”.

CD:

1.Stick an empty CD in the CD/DVD burner. Windows will display it as a disc on the desktop.

2.Right click on the file to export, in the case (Video or still) and choose “Save as”

3.Browse the CD and “Save”.

4.A dialog will show, asking you how to use the CD. Choose “Like a USB…” and windows will prepare/format the CD

5.Eject the CD

Instruction videos

DVD for TV

1.If you don’t have a suitable folder, create one for saving future videos.

2.Right click on the file to export, in the case (Video or still) and choose “Save as”

3.Browse the desktop to find your folder and “Save”.

4.Go to the desktop and start “Windows DVD Maker”

5.Drag the files from your folder to the Windows DVD maker dialog

6.Click on Burn DVD

7.Eject the DVD, when the software is done.

Instruction videos

Analyse

• Start Excel interactive mode under menu/Measure

• Choose template or empty

• Click the first cell where you want measures to appear. Depending if you have chosen vertical or horizontal feed, the measures will appear accordingly as you go.

• Delete (backspace) will also delete measures in Excel, one by one.

Advanced! Measure with ExcelAdvanced! Measure with Excel

When a case is locked in Picsara, the patient record in Meditech shall be updated with the following information:

For example:

A case with 5 images/videos was signed in Picsara by Dr. FeelGood.

Date: 01/01/2000 Time: 09:45

Case ID in Picsara: 5467

Procedure: ADL

Assessment: Reassessment

Comment: The patient has recovered well from the accident in January

:::::::::::::::::::::::::::::::::::::::::::::::::

In case a locked case is modified (that is, a copy is created) and the copy is locked, the patient record in Meditech shall be updated with the following information:

For example:

An addendum to Case 5467 has been made and signed in Picsara by Dr. Anderson.Date: 02/01/2000Time: 10:59New case ID in Picsara: 5564Procedure: ADLAssessment: ReassessmentComment: The patient has recovered well from the accident in January. The mobility is better than expected.

Feedback to Meditech

Patient update

•When patient demographics are updated in Meditech, an Update Patient Information (ADT^A08 HL7) message shall be sent from Meditech to Picsara and the corresponding patient demographics shall be updated in Picsara.

Patient Merge

•When patients are merged in Meditech, a Patient Merge (ADT^A40 HL7) message shall be sent from Meditech to Picsara and the corresponding patient shall be merged in Picsara.

Patient administration

• A common user directory.

• Only one username and password for multiple applications.

• Automatic synchronisation with Picsara

• The users will initially be active in Picsara with a default role. The user will be assigned to the department(s) from AD.

• If you need extended access, contact the Admininstrator.

User administration (AD)

Administration and settings(Advanced)

Admin

Admin

Admin

Admin

Admin, audit trail

Overview, supported interfaces

SQL

SAN

Client

ServerWeb services (API) DICOM

service

Client COM API

Lookup.dll plugin

External launch

Input devicesDirectShow/SDK

Fileshare

Database

Lookup.dll

Admin, external program

Admin, design print reports

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4 save template in the template folder

Client System Preferences

Admin Import folders

This sets Picsara to watch a folder or device for incoming files and import them automatically or manually to a case.

Input devices

Menu: File/Input devices

1 Choose type 2 Choose source 3 Add magnification

4 look for device in the menu

End